Endocrine Abstracts

1. A 48 year old female was admitted to inpatient psychiatry with paranoid delusions, auditory hallucinations and subsequently detained under the Mental Health Act of Scotland. She had been diagnosed with Graves’ Disease 5 years previously having presented with anxiety and weight loss but had elected to refuse anti-thyroid drugs in favour of homeopathy and acupuncture. She refused any treatment for Graves’ Disease when admitted to Psychiatry even though floridly thyr...

Metastatic disease to the thyroid is rare, accounting for 2–3% of thyroid malignancy. The most common malignancy to metastasise to thyroid is renal cell carcinoma (48.1%), followed by colorectal (10.4%) and lung (8.3%). Clinically, clear cell renal cell carcinoma (CCRCC) can present with thyroid metastases years or decades later. Several studies have shown that thyroid gland abnormalities, including nodular goitre or thyroiditis, are more likely to harbour metastases....

Introduction: Male hypogonadism is a clinical syndrome comprising symptoms, signs and biochemical evidence of testosterone deficiency due to primary testicular failure or secondary pituitary/hypothalamic disease. Management may vary. This audit aimed to assess adherence to Endocrine Society Clinical Practice guidelines in investigation and management of male hypogonadism.Methods: Electronic patient records for 25 men with hypogonadism attending endocrino...

Background: In 2013 the Diabetes Team at a large children’s hospital commenced ‘Pump School’ for all children and young people (CYP) transitioning from multiple daily injections to insulin pump therapy (CSII) using Medtronic, Accu-chek, Animas and Omnipod pumps.Aim: To provide CYP and their parents/carers with structured education to improve their outcomes including glycaemic control, hypoglycaemic episodes and quality of life (QOL).<p...

Background: Diabetes is a metabolic disorder characterized by chronic hyperglycaemia as a result of defective insulin secretion, insulin action or a combination. Poor glycaemic control increases the risk of microvascular and macrovascular complications. For group two driving license holders with diabetes there are specific requirements set out by the Driver and Vehicle Licensing Agency. It is therefore hypothesised that this patient group is likely to aim for less tight glycae...

Primary adrenal lymphoma is rare and accounts for <1% of extra-nodal non-Hodgkin’s lymphoma cases. It presents with B symptoms, bilateral adrenal masses and hypoadrenalism; and thought to have a poor prognosis. We describe a patient that was diagnosed with and successfully treated for primary adrenal diffuse large B cell lymphoma (DLBCL).Case: A 62-year-old gentleman with longstanding hypertension presented with a 5-month history of weight loss,...

The MEN1 gene is positioned on the long arm of chromosome 11 (11q13) and results in production of the protein menin. MEN1 mutations produce aberrant menin action or production, although the relationship with tumourigenesis is not clear. Mosaicism is extremely rare, a recent report citing two mosaic cases reported by next generation sequencing1. We describe a 43 year old woman with MEN1 mosaicism associated with parathyroid adenoma and probable pancreatic gastrinoma....

Introduction: Poor HbA1c in the first year following diagnosis of type 1 diabetes is a predictor of poor metabolic control and early development of complications. Achieving good glycaemic control requires compliant, well-educated patients. In October 2013, we introduced a revised and extended ‘Newly Diagnosed Patient Education Programme’ in which a total of 20 sessions are delivered by the multidisciplinary team.Aim: To assess the effect of the...

Spindle Cell Oncocytoma (SCO) is a neoplasm of the adenohypophysis, often pre-operatively misdiagnosed as pituitary macroadenoma due to its rarity. First described in 2002, 28 cases have been described. It is a benign tumour manifesting in adults with no sex predilection, classified as WHO Grade I. A 71-year-old woman presented with bitemporal hemianopia, secondary hypoadrenalism, hypothyroidism and hypogonadotrophic hypogonadism. Imaging in October 2017 confirmed a 18.0×...

Primary adrenal lymphoma is a rare phenomenon with a male preponderance. There is bilateral gland involvement in two thirds of cases. Histology usually reveals an aggressive diffuse large B-cell subtype. Adrenal insufficiency is a recognised complication. We present a 62 year old man with a 4 month history of weight loss, night sweats and malaise. Clinical examination revealed right renal angle tenderness with no palpable lymphadenopathy. Inflammatory markers were raised with ...